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11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters
11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters
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Like the convenience of an instant PDF download but still want a hard copy of this book? Order both and save 35 percent!

CMS's ambitious agenda for moving Medicare into alternative payment models is driving the U.S. healthcare system toward greater value-based purchasing at a furious rate.

Private payors also have pledged to continue to shift payments away from fee for service and into alternative payment models such as accountable care organizations (ACOs).

Fortunately, many healthcare organizations are already exploring value-based payments—often a single innovation at a time—testing models that reward providers for meeting Triple Aim goals of improving patient experience and population health while reducing healthcare's per capita cost.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters encapsulates nearly a dozen such approaches, from Bon Secours' building of a business case for its multidisciplinary care team to the John C. Lincoln ACO's deep dive into data analytics to identify and manage the care of high-risk, high-cost 'VIP' patients to 'beat the benchmark' to WellPoint's engagement of specialists in care coordination.

There is also a look at the value proposition inherent in Medicare's recently announced Chronic Care Management codes.

There are many lessons to learn from the 11 models outlined in this 30-page quick reference, which summarizes hours of thought leadership on the shifting healthcare payment landscape. These synopses are highlighted with key charts from the value-based initiatives.

11 Profitable Value-Based Reimbursement Models: Lessons from Early Adopters includes a look at drivers behind healthcare's transition to value as well as some new players and 'disruptive innovators' to monitor during the industry's new era.

Table of Contents:

  • How Bon Secours Gets Paid for Providing Value-Based Healthcare
  • Humana Physician Quality Rewards Boost Population Health across Accountable Care Continuum
  • 3 Factors Driving Healthcare’s Transition from Volume to Value
  • Healthcare Strategy Group: 4 Factors Driving Resurgence of the PHO Model
  • WellPoint Care Coordination Compacts Establish Accountability, Clarity between Physicians and Specialists
  • BCBS Michigan Physician Value Partnership Translates to Quality Improvement, Cost Savings
  • Optum’s 3 Essentials for Shift to Value-Based Physician Compensation
  • WellPoint ‘Leaves No Primary Care Practice Behind’ on Road to Value-Based Payment Reform
  • Monarch Pioneer ACO to Specialists: If Care Coordination Role Fits, Wear It
  • John C. Lincoln’s Deeper Data Dive Improves ACO Performance, Quality
  • Medicare Chronic Care Management Code: Arnold & Porter Test-Drive Value-Based Healthcare Delivery Model
  • For More Information
  • About the Thought Leaders
Publication Date: July 2015
Number of Pages: 30
ISBN 10: 1-941329-80-2 (Print version); 1-941329-81-0 (PDF version)
ISBN 13: 978-1-941329-80-1 (Print version); 978-1-941329-81-8 (PDF version)
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